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Audit
10 February 2018 - 9:14, by , in Blog, Compliance, Comments off
The Recovery Audit Contractor (RAC) Performant Recovery, Inc. announced last month that they will conduct a complex home health review for documentation and medical necessity. They will do an annual additional development request (ADR) limit that will be one-half percent (0.5%) of the total Medicare paid claims from the previous year.
15 December 2017 - 10:18, by , in Blog, Compliance, Comments off
Check out these tips when coding blindness and low vision. Documentation training and education is crucial to correctly code blindness and low vision conditions. Category-level tabular instruction at H54.- (Blindness and low vision) requires...
Conditions of Participation
20 November 2017 - 11:21, by , in Blog, Post Acute, Comments off
CMS released a draft of the home health conditions of participation - CoPs - for review and comment to select industry groups. The CoPs have been regrouped into three sections--General Provisions, Patient Care, and Organizational Environment
Conditions of Participation
20 November 2017 - 9:18, by , in Blog, Post Acute, Comments off
On October 27, 2017, CMS released a draft of the home health conditions of participation - CoPs - for review and comment to select industry groups.
Hospice Targeted Probe and Educate
9 November 2017 - 14:39, by , in Blog, Compliance, Comments off
Last month, Centers for Medicare and Medicaid Services (CMS) expanded the Targeted Probe and Educate (TPE) to include Hospice.
proposed hhgm
19 September 2017 - 1:00, by , in Blog, Post Acute, Comments off
This summer, CMS unveiled an overhaul to the Medicare payment system – a new home health groupings model (HHGM) to replace the current Home Health Prospective Payment System. In this video, Mike Dordick, EVP, Principal, evaluates key areas...
30 August 2017 - 18:28, by , in Blog, Compliance, Comments off
Due to the success of the Probe and Educate pilot from June 2016 to July 2017, CMS has announced that it will expand the initiative to all Medicare providers...
30 August 2017 - 18:26, by , in Blog, Post Acute, Comments off
The proposed Home Health Groupings Model (HHGM) is enormously complex. As a result, we have identified the key elements that change with the implementation of HHGM as its proposed today...
Utilization Review
26 March 2018 - 12:07, by , in Acute, Blog, Comments off
Centralizing Utilization Review Functions is a cost-saving quality improvement measure, closes gap in coverage due to inter-rater reliability. Many forward-thinking organizations recognize the negative financial impact of inaccurate or non-existent UR. Learn how it's worked for a large, newly formed health system...
21 December 2017 - 11:27, by , in Acute, Blog, Comments off
With little time until the 2018 Medicare OPPS final rule goes into effect, finance leaders should take action now to address the key issues that may impact their organizations both financially and operationally.